Gout Attack

An Attack of Gout

A gout attack usually occurs at night and is most common in the joint at the base of the big toe, popularly characterized as "gout big toe." What can you do to stop the pain and prevent another gout attack? Victims of acute gout attacks report that they cannot even have a light sheet or blanket touch the inflammed joint and it is impossible to put on shoes or stockings if the joint attacked is the big toe. An attack of gout can cause severe pain, heat, swelling, redness,  and stiffness. Symptoms similar to an infection can occur, such as a low grade fever and chills.

Uric Acid - the Culprit!

A gout attack is brought on by an excess of uric acid in the body which leads to the deposit of urate crystals in the fluid and joint lining of the affected joint. The body sends white blood cells to the affected area to combat the build up of the urate crystals and this is what causes the extreme gout pain. Many people can have elevated levels of uric acid in their blood for several years before they have a gout attack. Some people never have a gout attack even if their uric acid level is high. On the other hand, some people who do not have elevated levels of uric acid in their blood are vicitims of acute gout attacks.

Other Causes

Stress, alcohol or drugs, illnesses, eating foods high in purines are just some of the factors that can lead to a gout attack.  Attacks can last from just a few hours to many weeks, but the typical attack lasts from three to ten days. Some people will experience attacks of gout several times during their lifetimes and other people may have only one or two attacks.

An Ancient Attack Described - from 1683

History has recorded gout attacks more often than any other illness. Gout used to be referred to as the "rich man's disease" because it seemed to occur more in men who were well fed and who drank a lot of alcoholic beverages. Over the centuries, many different gout cures have been tried, but the best cure is learning how to prevent gout attacks from starting. Here is a description of a gout attack written by Dr. Thomas Sydenham in 1683. Dr. Sydenham was a victim of gout:

"The victim goes to bed and sleeps in good health. About 2 o'clock in the morning, he is awakened by a severe pain in the great toe; more rarely in the heel, ankle or instep. This pain is like that of a dislocation, and yet the parts feel as if cold water were poured over them. Then follows chills and shiver and a little fever. The pain which at first moderate becomes more intense. With its intensity the chills and shivers increase. After a time this comes to a full height, accommodating itself to the bones and ligaments of the tarsus and metatarsus. Now it is a violent stretching and tearing of the ligaments-- now it is a gnawing pain and now a pressure and tightening. So exquisite and lively meanwhile is the feeling of the part affected, that it cannot bear the weight of bedclothes nor the jar of a person walking in the room."

Who is at risk?

Nine times more men than women are affected by gout. Women aren't usually victims of gout until after menopause. People who are at high risk of becoming victims of gout - those who are overweight and/or who eat foods high in purines, or who consume an excess of alcoholic beverages, or people who have a family history of gout - should take steps early on to change their lifestyles to reduce the chances of a gout attack occurring later in life.